ABSTRACT
Objective: The purpose of this study was to compare between temporalis fascia and composite cartilage perichondrium grafts in reconstruction of the total and subtotal tympanic membrane perforations
Study Design: Prospective study consisted of ninety five consenting patients with chronic inactive suppurative otitis media with total and subtotal perforations. The patients were classified into two groups; group A [75 ears in 75 patients] in whom cartilage graft was used and group B [20 ears in 20 patients] in whom temporalis fascia was used
Results: For group A tymapanic membrane closure was achieved in 71 patient [94.6%] while in group B tympanic membrane closure was achieved in 7 patients [35%]. The hearing results showed that, there was highly significant postoperative improvement in pure tone averages as well as air bone gap averages. In group A the air bone gap was closed to less than 10 dB in 21.7% and from 10 to 25 dB in 73.9% and to more than 25 dB in 4.4 %, on the other hand the air bone gap was closed to less than 10 dB in 16.7 % and from 10 to 25 dB in 66.6 % and to more than 25 dB in 16.7 % in group B. In this study, the average pre and postoperative air bone gap [500-4000 Hz] were 26.8 dB and 13 dB respectively, for cartilage group and 25.1 dB and 12.3 dB for fascia group
Conclusions: This study revealed that Composite cartilage perichondrial grafts are excellent graft material for total and subtotal perforations. The palisade technique is an effective and straight forward technique with high success rate and good hearing results with no postoperative complications
ABSTRACT
This study included 199 cases suffering from inactive chronic suppurative otitis media and operated up on at the Otorhinolaryngology Department Mansoura University from 2000 to 2003. Patients were divided into 3 groups according to their Eustachian tube function [good, fair and poor]. Tympanoplasties were done using 3 types of graft materials [full thickness cartilage graft, partial thickness cartilage graft and temporalis fascia graft]. The take rate was better with good Eustachian tube function than poor Eustachian tube function in the 3 groups, in fascia group there was a significant difference between good and poor Eustachian tube function. There was no significant difference in hearing results between the fascia group and cartilage groups. Type A tympanogram was obtained in partial thickness cartilage graft and temporalis graft more than the full thickness cartilage graft. According to our results the use of cartilage is the preferred graft material for tympanoplasty in cases with poor Eustachian tube function
ABSTRACT
Management of malignant Sino nasal tumors with skull base involvement constitutes a challenging problem for head and neck surgeons. Surgery in this area confronts with life threatening risks of infections, orbital complications and cerebrospinal fluid leaks. Avoidance of these complications demand the co-operation between head and neck surgeons, neurosurgeons and radiotherapists, high surgical experience as well as proper reconstruction of skull base. The aim of this work is to study retrospectively the complications of anterior craniofacial resection for malignant Sino nasal tumors involving anterior skull base and to find out how to minimize these complications. In this study, we reviewed retrospectively the complications of twenty-one craniofacial resections done in Otolaryngology department Mansoura University Hospital. From September 1996 lo January 2004 with median follow-up period of 22 months. From this study, we found that the overall complications rate was about 30%. Anosmia. and psychological changes were the commonest complications and infectious complications were the least. We concluded that most of the complications of craniofacial resection are avoidable by good selection of patients, high surgical experience, and proper reconstruction of the anterior cranial base and good postoperative care